Physical Function and Physical Activity in Peritoneal Dialysis Patients

2017 ◽  
Vol 37 (6) ◽  
pp. 598-604 ◽  
Author(s):  
Patricia L. Painter ◽  
Adhish Agarwal ◽  
Micah Drummond

BackgroundPhysical functioning (PF) and physical activity (PA) are low in patients treated with maintenance hemodialysis (MHD). Little information exists on this topic in patients treated with peritoneal dialysis (PD). The objective of this study was to compare PF and PA in patients with Stage-5 chronic kidney disease (CKD) treated with PD and in-center MHD.MethodsPhysical functioning was measured in 45 prevalent PD patients using standard physical performance measures that include gait speed, chair stand, standing balance, 6-minute-walk, incremental shuttle walk and self-reported PF using the short form (SF)-36 questionnaire. Physical activity was determined from self-report and using the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Scores for the short physical performance battery (SPPB) were calculated. In-center MHD patients were matched by age, gender, and diabetes status to the PD patients.ResultsUnadjusted comparisons showed significantly higher 6-minute-walk distance, shuttle-walk distance and hand-grip in the PD patients. Adjustment in multiple regression analysis resulted in only gait speed being significantly different between the groups. All test results in both groups were lower than reference values for age and gender in the general population, and were at the levels indicating impairment. Physical activity was not different between the 2 groups (average age 49 yrs), and both groups had weekly caloric expenditure from all exercise and from moderate-intensity exercise that was similar to older (> 70 yrs) community-dwelling adults. Adjusted association indicated that PA was significantly associated with shuttle-walk distance.ConclusionsPhysical functioning and PA measures were low in both PD and MHD groups. Interventions to improve PA and PF should be strongly considered for both PD and MHD patients.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 194-195
Author(s):  
Kaiyuan Hua ◽  
Sheng Luo ◽  
Katherine Hall ◽  
Miriam Morey ◽  
Harvey Cohen

Abstract Background. Functional decline in conjunction with low levels of physical activity has implications for health risks in older adults. Previous studies have examined the associations between accelerometry-derived activity and physical function, but most of these studies reduced these data into average means of total daily physical activity (e.g., daily step counts). A new method of analysis “functional data analysis” provides more in-depth capability using minute-level accelerometer data. Methods. A secondary analysis of community-dwelling adults ages 30 to 90+ residing in southwest region of North Carolina from the Physical Performance across the Lifespan (PALS) study. PALS assessments were completed in-person at baseline and one-week of accelerometry. Final analysis includes 669 observations at baseline with minute-level accelerometer data from 7:00 to 23:00, after removing non-wear time. A novel scalar-on-function regression analysis was used to explore the associations between baseline physical activity features (minute-by-minute vector magnitude generated from accelerometer) and baseline physical function (gait speed, single leg stance, chair stands, and 6-minute walk test) with control for baseline age, sex, race and body mass index. Results. The functional regressions were significant for specific times of day indicating increased physical activity associated with increased physical function around 8:00, 9:30 and 15:30-17:00 for rapid gait speed; 9:00-10:30 and 15:00-16:30 for normal gait speed; 9:00-10:30 for single leg stance; 9:30-11:30 and 15:00-18:00 for chair stands; 9:00-11:30 and 15:00-18:30 for 6-minute walk. Conclusion. This method of functional data analysis provides news insights into the relationship between minute-by-minute daily activity and health.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ewelina Akehurst ◽  
David Scott ◽  
Juan Peña Rodriguez ◽  
Carol Alonso Gonzalez ◽  
Jasmaine Murphy ◽  
...  

Abstract Background The risk of progressive declines in skeletal muscle mass and strength, termed sarcopenia, increases with age, physical inactivity and poor diet. The purpose of this study was to explore and compare associations of sarcopenia components with self-reported physical activity and nutrition in older adults participating in resistance training at Helsinki University Research [HUR] and conventional gyms for over a year, once a week, on average. Methods The study looked at differences between HUR (n = 3) and conventional (n = 1) gyms. Muscle strength (via handgrip strength and chair stands), appendicular lean mass (ALM; via dual energy X-ray absorptiometry) and physical performance (via gait speed over a 4-m distance, short physical performance battery, timed up and go and 400-m walk tests) were evaluated in 80 community-dwelling older adults (mean ± SD 76.5 ± 6.5 years). Pearson correlations explored associations for sarcopenia components with self-reported physical activity (via Physical Activity Scale for the Elderly [PASE]) and nutrition (via Australian Eating Survey). Results No differences in PASE and the Australian Recommended Food Score (ARFS) were observed between HUR and conventional gyms, however HUR gym participants had a significantly higher self-reported protein intake (108 ± 39 g vs 88 ± 27 g; p = 0.029) and a trend to have higher energy intake (9698 ± 3006 kJ vs 8266 ± 2904 kJ; p = 0.055). In both gym groups, gait speed was positively associated with self-reported physical activity (r = 0.275; p = 0.039 and r = 0.423; p = 0.044 for HUR and conventional gyms, respectively). ALM was positively associated with protein (p = 0.047, r = 0.418) and energy (p = 0.038, r = 0.435) intake in the conventional gym group. Similar associations were observed for ALM/h2 in the HUR group. None of the sarcopenia components were associated with ARFS in either gym group. Conclusion Older adults attending HUR and conventional gyms had similar self-reported function and nutrition (but not protein intake). Inadequate physical activity was associated with low gait speed and inadequate nutrition and low protein ingestion associated with low lean mas, even in older adults participating in exercise programs. Optimal physical activity and nutrition are important for maintaining muscle mass and function in older adults.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Baback Roshanravan ◽  
Bryan Kestenbaum ◽  
Jaimie Giffuni ◽  
Cassiane Robinson-Cohen ◽  
Leslie I Katzel ◽  
...  

Background: Kidney dysfunction leads to the retention of metabolic waste products which may subsequently impair muscle function and physical performance. Methods: We prospectively measured physical performance in 183 stroke-free older adults with stage 3-4 CKD to determine the pattern of functional impairment and the relationship of performance with severity of CKD. Functional tests included the short physical performance battery (SPPB), 4 meter walk (gait speed), 6 minute walk distance (6MWD), timed get up and go test (TGUAG), grip strength, and peak expiratory flow. Physical performance in the CKD cohort was compared to normative data obtained from 78 non-CKD controls for the TGUAG and to expected performance from published normative data for other performance measures. Among CKD subjects, associations of performance with eGFR and proteinuria were estimated using linear regression adjusting for age, sex, race, height, and weight. Results: Mean eGFR was 34.8 ±12.5 mL/min/1.73m 2 , mean BMI 30.6 ±6 kg/m 2 , and median proteinuria 240 mg/g. Mean age was 66 ±7.7years, 91% were male, 33% African American, and 40% diabetic. CKD patients had significantly worse performance compared to predicted values on the TGUAG test (36 ±41% slower), gait speed (-31.7 ±15%), 6MWD (-31 ±15%), and peak expiratory flow (-25 ±34%). Among CKD subjects, lower eGFR and greater proteinuria were associated with worse performance on the 6MWD ( Table ). In contrast, no significant associations were observed between eGFR or proteinuria with performance on the other physical performance tests. Renal Function Measure 6 Meter Walk Distance (meters) Units β * (95%CI) P value GFR MDRD (mL/min/1.73m 2) 10mL/min/1.73m 2 decrement −11.0 (-23.0, 1.1) 0.07 45-59 Ref 30-44 −7.0 (-38, 24) .044 <30 −35 (-68, -1.3) Proteinuria (mg/g Cr) 1 ln-increment −11.0 (-21.1, -0.9) 0.033 0-299 Ref ≥300 −25.8 (-53, 1.38) 0.063 * Adjusted for age, sex, race, height, and weight Conclusions: Older adults with CKD exhibit markedly reduced physical performance, especially for tests of lower extremity function. Lower renal function and greater proteinuria are associated with worse performance on the 6-minute walk test, a measure of submaximal gait.


2020 ◽  
Author(s):  
Ewelina Akehurst ◽  
David Scott ◽  
Juan Peña Rodriguez ◽  
Carol Alonso Gonzalez ◽  
Jasmaine Alyce Murphy ◽  
...  

Abstract Background: The risk of progressive declines in skeletal muscle mass and strength, termed sarcopenia, increases with age, physical inactivity and poor diet. The purpose of this study was to explore associations of sarcopenia components with self-reported physical activity and nutrition in older adults participating in resistance training at conventional or Helsinki University Research [HUR] gyms. Methods: Muscle strength (via handgrip strength and chair stands), appendicular lean mass [ALM] (via dual energy X-ray absorptiometry) and physical performance (via gait speed over a 4-metre distance, short physical performance battery, timed up and go and 400-metre walk tests) were evaluated in a cohort study of 80 community-dwelling older adults (mean±SD 76.5B6.5 years). Pearson correlations explored associations for sarcopenia components with self-reported physical activity (via Physical Activity Scale for Elderly [PASE]) and nutrition (via Australian Eating Survey), with higher scores indicative of greater physical activity levels and better nutrition, respectively. Results: No differences in PASE were observed between HUR and conventional gyms, however HUR gym participants had a significantly higher self-reported protein intake and a trend (p = 0.055) to have higher energy intake. In both gym groups, gait speed was positively associated with self-reported physical activity (r = 0.275; p = 0.039 and r = 0.423; p = 0.044 for HUR and conventional gyms, respectively). ALM was positively associated with protein (p = 0.047, r = 0.418) and energy (p = 0.038, r = 0.435) intake in the conventional gym group. Similar associations were observed for ALM/h2 in the HUR group. None of the sarcopenia components were associated with the Australian Recommended Food Score (derived from the Australian Eating Survey) in either gym group.


2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
R R Chungath ◽  
M D Witham ◽  
C L Clarke ◽  
A Hutcheon ◽  
S Gandy ◽  
...  

Abstract Background Mitochondrial dysfunction has been proposed as a therapeutic target to improve muscle strength and endurance, but the contribution that mitochondrial dysfunction makes to impaired skeletal muscle performance in older people remains unclear. We studied the relationship between phosphocreatine recovery rate (a measure of skeletal muscle mitochondrial function) and physical performance in older people. Methods We analysed data from the Allopurinol in Functional Impairment (ALFIE) trial. Participants aged 65 and over, who were unable to walk 400 m in six minutes, underwent 31P magnetic resonance spectroscopy of the calf after exercise at baseline and at 20 weeks follow up. The phosphocreatine recovery half-life time (t-half) was derived as a measure of mitochondrial function. Participants also undertook the 6-minute walk distance, the Short Physical Performance Battery test (SPPB), and had muscle mass measured using bio-impedance analysis. Bivariate correlations and multivariable regression analyses were conducted to determine associations between t-half and baseline factors. Results One hundred and seventeen people underwent baseline 31P magnetic resonance spectroscopy, mean age 80.4 years (SD 6.0); 56 (48%) were female. Mean 6-minute walk was 291 m (SD 80) and mean SPPB score was 8.4 (SD 1.9). T-half was significantly correlated with SPPB score (r = 0.22, p = 0.02) but not with 6-minute walk distance (r = 0.10, p = 0.29). In multivariable linear regression, muscle mass and weight, but not t-half, were independently associated with SPPB score and with 6-minute walk distance. The change in t-half between baseline and 20 weeks was not significantly associated with the change in SPPB (r = 0.03, p = 0.79) or with the change in 6-minute walk distance (r = −0.11, p = 0.28). Conclusion Muscle mass, but not phosphocreatine recovery time, was associated with Short Physical Performance Battery score and 6-minute walk distance in this cohort of older people with functional impairment.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050550
Author(s):  
Gavin R McCormack ◽  
Patricia K Doyle-Baker ◽  
Jennie A Petersen ◽  
Dalia Ghoneim

ObjectivesThe COVID-19 pandemic changed daily routines, including physical activity, which could influence physical and mental health. In our study, we describe physical activity and sedentary behaviour patterns in relation to the pandemic and estimate associations between anxiety and physical activity and sedentary behaviour in community-dwelling adults.DesignCross-sectional study.SettingCalgary, Alberta, Canada.ParticipantsBetween April and June 2020, a random sample of 1124 adults (≥18 years) completed an online questionnaire.Primary and secondary outcomesThe online questionnaire captured current walking, moderate intensity, vigorous intensity and total physical activity and sedentary behaviour (ie, sitting and leisure-based screen time), perceived relative changes in physical activity, sedentary and social behaviours since the pandemic, perceived seriousness and anxiety related to COVID-19, and sociodemographic characteristics. Differences in sociodemographic characteristics, perceived relative change in behaviour and current physical activity and sedentary behaviour were compared between adults with low and high anxiety.ResultsOur sample (n=1047) included more females (60.3%) and fewer older adults (19.2%). Most participants (88.4%) considered COVID-19 as extremely or very serious and one-third (32.9%) felt extremely or very anxious. We found no differences (p>0.05) in current physical activity or sedentary behaviour by anxiety level. The largest perceived change in behaviours included social distancing, driving motor vehicles, use of screen-based devices, watching television and interactions with neighbours. We found anxiety-related differences (p<0.05) in perceived changes in various behaviours.ConclusionsChanges in physical activity, sedentary behaviour and social behaviour occurred soon after the COVID-19 pandemic was declared, and some of these changes differed among those with low and high anxiety.


2020 ◽  
Vol 75 (10) ◽  
pp. 1967-1973
Author(s):  
Deepika R Laddu ◽  
Neeta Parimi ◽  
Katie L Stone ◽  
Jodi Lapidus ◽  
Andrew R Hoffman ◽  
...  

Abstract Background Physical activity (PA) is important to maintaining functional independence. It is not clear how patterns of change in late-life PA are associated with contemporaneous changes in physical performance measures. Methods Self-reported PA, gait speed, grip strength, timed chair stand, and leg power were assessed in 3,865 men aged ≥ 65 years at baseline (2000–2002) and Year 7 (2007–2009). Group-based trajectory modeling, using up to four PA measures over this period, identified PA trajectories. Multivariate linear regression models (adjusted least square mean [95% confidence interval {CI}]) described associations between-PA trajectories and concurrent changes in performance. Results Three discrete PA patterns were identified, all with declining PA. Linear declines in each performance measure (baseline to Year 7) were observed across all three PA groups, but there was some variability in the rate of decline. Multivariate models assessing the graded response by PA trajectory showed a trend where the high-activity group had the smallest declines in performance while the low-activity group had the largest (p-for trend &lt; .03). Changes in the high-activity group were the following: gait speed (−0.10 m/s [−0.12, −0.08]), grip strength (−3.79 kg [−4.35, −3.23]), and chair stands (−0.38 [−0.50, −0.25]), whereas changes in the low-activity group were the following: gait speed (−0.16 [−0.17, −0.14]), grip strength (−4.83 kg [−5.10, −4.55]), and chair stands (−0.53 [−0.59, −0.46]). Between-group differences in leg power trajectories across PA patterns were not significant. Conclusions Declines in functional performance were higher among those with lower PA trajectories, providing further evidence for the interrelationship between changes in PA and performance during old age.


2005 ◽  
Vol 13 (3) ◽  
pp. 239-253 ◽  
Author(s):  
Kristin Musselman ◽  
Brenda Brouwer

This study examined gender differences in balance, gait, and muscle performance in seniors and identified gender-specific factors contributing to physical performance. Forty (20 men, 20 women) healthy, community-dwelling seniors (74.5 ± 5.3 years) participated. Limits of stability, gait speed, lower limb flexor and extensor isokinetic concentric peak torques, self-reported activity level, and balance confidence were measured. No gender differences were detected in gait speed, limits of stability when normalized to height, activity level, or balance confidence (p≥ .188). Women were weaker than men (p≤ .007), even after controlling for weight and body-mass index, suggesting that other gender-related factors contribute to strength. Gender accounted for 18–46% of the variance in strength and served as a modifier of the relationship between activity level and strength in some muscle groups. The primary factors relating to gender-specific strength was activity level in men and body weight in women.


Author(s):  
Jenna M Napoleone ◽  
Robert M Boudreau ◽  
Brittney S Lange-Maia ◽  
Samar R El Khoudary ◽  
Kelly R Ylitalo ◽  
...  

Abstract Background Little is known about how adverse, midlife metabolic profiles impact future physical functioning. We hypothesized that a higher number of midlife metabolic syndrome (MetS) components are associated with poorer physical performance in early old age for multi-ethnic women. Methods MetS status from 1996-2011 (8 visits) and objective physical performance in 2015/2016 (short physical performance battery (SPPB; 0-12), 40-foot walk (m/s), 4-meter gait speed (m/s), chair stands (sec), stair climb (sec)) were assessed in the Study of Women’s Health Across the Nation (SWAN; n=1722; age 65.4±2.7 years; 26.9% African American, 10.1% Chinese, 9.8% Japanese, 5.5% Hispanic). Poisson latent class growth modeling identified MetS component trajectory groups: none (23.9%), 1=low-MetS (28.7%), 2=mid-MetS (30.9%), and &gt;3=high-MetS (16.5%). Adjusted linear regression related MetS groups to physical performance outcomes. Results High-MetS versus none had higher BMI, pain, financial strain, and lower physical activity and self-reported health (p&lt;0.0001). Compared to White, African American and Hispanic women were more likely to be in the high-MetS groups and had worse physical functioning along with Chinese women (SPPB, chair stand, stair climb, and gait speed - not Hispanic). After adjustments, high-MetS versus none demonstrated significantly worse 40-ft walk (β:-0.08; 95% CI:-0.13, -0.03), gait speed (β:-0.09; 95% CI:-0.15, -0.02), SPPB (β:-0.79; 95% CI: -1.15, -0.44), and chair stands (β:0.69; 95% CI: 0.09, 1.28), but no difference in stair climb. Conclusions Midlife MetS groups were related to poor physical performance in early old age multi-ethnic women. Midlife management of metabolic function may improve physical performance later in life.


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